Hypertension:肾素-血管紧张素-醛固酮系统抑制剂治疗降低伴有高血压的 COVID-19患者死亡率

2020-05-28 MedSci原创 MedSci原创

ACEI/ARB治疗不会加剧COVID-19患者的疾病严重程度。此外,ACEI/ARB治疗可以降低COVID-19患者的死亡率。

冠状病毒病2019(COVID-19)是由严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)感染引起的,已发展成大流行并危及全球健康。COVID-19高血压患者是否继续使用血管紧张素转换酶抑制剂(ACEIs)和血管紧张素II受体阻滞剂(ARBs)已引起争议。

近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员进行了荟萃分析,检索了Pubmed、Web of Science、Scopus和Embase,检索时间截止至2020年5月13日。数据分析由Cochrane Collaboration的Review Manager 5.3软件进行。

研究人员纳入了9项研究,包含3936例伴有高血压的COVID-19患者。与非ACEI/ARB治疗相比,ACEI/ARB治疗与疾病严重程度无关(OR为0.71,95%CI为0.46-1.08,P=0.11,I2=59%),但与COVID-19感染的高血压患者死亡率降低有关(OR为0.57,95%CI为0.38-0.84,P=0.004,I2=0)。

总而言之,ACEI/ARB治疗不会加剧COVID-19患者的疾病严重程度。此外,ACEI/ARB治疗可以降低COVID-19患者的死亡率。目前的证据表明,在COVID-19感染的高血压患者中应继续使用RAAS抑制剂。未来需要设计良好的随机对照试验来证实这些结果。

原始出处:

Xiaoming Guo.et al.Decreased Mortality of COVID-19 with Renin-Angiotensin-Aldosterone System Inhibitors Therapy in Patients with Hypertension: A Meta-Analysis.Hypertension.2020.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15572

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    2020-09-29 jklm09
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createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Sat May 30 05:34:59 CST 2020, time=2020-05-30, status=1, ipAttribution=)]
    2021-04-14 feather89
  5. 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  6. 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createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Sat May 30 05:34:59 CST 2020, time=2020-05-30, status=1, ipAttribution=)]
  7. 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style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Sat May 30 05:34:59 CST 2020, time=2020-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379251, encodeId=017a13e925141, content=<a href='/topic/show?id=ac549564240' target=_blank style='color:#2F92EE;'>#醛固酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95642, encryptionId=ac549564240, topicName=醛固酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Sat May 30 05:34:59 CST 2020, time=2020-05-30, status=1, ipAttribution=), 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createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Sat May 30 05:34:59 CST 2020, time=2020-05-30, status=1, ipAttribution=)]
    2020-05-30 cmsvly
  8. 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